How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $524.81 Median $3,548.13 Typical High $4,786.30 | Facility | None | $524.81 | $3,548.13 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $457.09 Median $524.81 Typical High $524.81 | Professional | None | $457.09 | $524.81 | $524.81 |
CareFirst Setting Professional Modifier None Typical Low $501.19 Median $562.34 Typical High $5,011.87 | Professional | None | $501.19 | $562.34 | $5,011.87 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $512.86 Typical High $1,445.44 | Professional | None | $467.74 | $512.86 | $1,445.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $489.78 Median $1,000.00 Typical High $1,202.26 | Professional | None | $489.78 | $1,000.00 | $1,202.26 |
United Setting Facility Modifier None Typical Low $537.03 Median $2,511.89 Typical High $27,542.29 | Facility | None | $537.03 | $2,511.89 | $27,542.29 |
United Setting Professional Modifier None Typical Low $380.19 Median $707.95 Typical High $1,445.44 | Professional | None | $380.19 | $707.95 | $1,445.44 |
6 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $245.47 Median $263.03 Typical High $263.03 | Professional | 52 · Reduced service | $245.47 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $104.71 Typical High $104.71 | Professional | 53 · Discontinued | $97.72 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $389.05 Typical High $398.11 | Professional | 54 · Surgery only | $363.08 | $389.05 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $77.62 Typical High $79.43 | Professional | 55 · Aftercare only | $72.44 | $77.62 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $52.48 Typical High $52.48 | Professional | 56 · Pre-op care only | $48.98 | $52.48 | $52.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $363.08 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $338.84 | $363.08 | $371.54 |
Where Washington, DC sits
The same service costs 6.3 times more in Alaska than in Utah. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Washington, DC· 36th of 51
$562
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.